Diabetes is a chronic medical condition that affects 540 million people around the world. There is currently no cure. However, there are a range of medical devices and medications that are used to manage the condition.
Left untreated, Diabetes is deadly, so managing it is a continuous daily activity. One of the most popular methods of self-management is by using a type of device called a Continuous Glucose Monitor (CGM).
In this article we are going to look at CGM’s and how people living with Diabetes use them to manage their condition.
What is Diabetes?
There are thirteen types of Diabetes, all of which concern the pancreas, insulin, and glucose. As humans, we need glucose to pass into cells from the bloodstream; this is what gives us energy. All carbohydrate in foods consumed is converted into glucose, and then the hormone insulin helps move the glucose from the blood into the cells.
Being unable to produce insulin, not produce enough, or not use it efficiently, means the blood has too much glucose that can’t go anywhere. High amounts of glucose in the blood leads to a variety of medical complications including damage to organs and body tissue.
The three main types of Diabetes are type 1, type 2, and gestational. Type 1 Diabetes is an autoimmune condition that can affect anyone but tends to develop more in children and young adults. This is when the body does not make any insulin. Instead, insulin injections are needed every day to keep the glucose levels in blood at a normal level.
Type 2 Diabetes is when the body makes insulin but doesn’t use it well enough. This is the most common type of Diabetes; around 90% of people with Diabetes have type 2. Type 2 Diabetes is most commonly linked with living unhealthily. Examples are, being too sedentary, overweight, or smoking. However, there is also a genetic component, and it can also occur in those leading healthy lifestyles. To try and avoid developing it, doctors recommend a healthy lifestyle. This means plenty of exercise and nutritious food, and avoiding too much sugar.
Gestational Diabetes develops when the normal amount of insulin resistance as part of pregnancy goes too high. Although gestational Diabetes can go away after giving birth, having it can increase the risk of the mother and child developing type 2 Diabetes later in life. It is important that the condition is well managed during pregnancy, otherwise, it can lead to complications at birth.
How do continuous glucose monitors (CGM’s) work?
A CGM is a small device that attaches to the skin. Made of plastic, varying in size and design, CGM’s have a tiny needle or sensor attached. This penetrates the top layers of skin and this sits in the arm to gather glucose measurements. Medical adhesive on the underside of the device holds it in place.
Instead of checking your blood, the CGM uses the tiny needle/sensor to measure glucose levels in your interstitial fluid. This is the fluid that fills the spaces between cells. Using blood to check glucose levels means pricking somewhere like a finger, at least several times a day. This draws a drop of blood and checking it using a blood glucose tester. A CGM provides around the clock glucose measurement readings to the patient. This can be without the need for any finger pricking (unless required for driving). Current CGM’s on the market will work for up to 14 days before they need replacing.
Many of the CGM models have built-in alarms. These alert wearers when their glucose levels are too high or too low before they start feeling the ill effects of those symptoms. This enables patients to get a much more comprehensive understanding of their glucose levels than if they were to rely only on blood glucose testing. This is because wearers can check their glucose levels more often with a CGM and wear it whilst they are sleeping, showering, and even swimming. This information is also of great value to the patient’s clinicians, providing daily trends and patterns on the patients blood glucose levels.
As a CGM measures glucose through the interstitial fluid, it can have a time lag of about 10 minutes. Blood is a more accurate way to measure glucose levels, so patients are encouraged to still conduct regular blood glucose tests.
How self-management works
Self-management can be a little different for everyone. The 540 million people with Diabetes are not all having the same experience, even though they all have the same condition. Because there are so many factors that make every Diabetic’s experience unique, their individual self-management will also be different.
That said, most CGM’s work on a similar concept as each other and there are aspects of self-management that CGM users will all do.
We’ve asked one of our staff here at Afon Technology who lives with Type 1 Diabetes to answer some questions about how they use a CGM to give our readers an idea of how CGM’s help people manage their Diabetes.
What does your CGM do?
My CGM allows me to know my glucose levels with speed and ease throughout the day. Basically, whilst on the go, as I don’t need to stop and do a finger prick. It is also great for during the night. It will alarm me if my blood glucose goes out of range, waking me up so I can treat.
What does your CGM look and feel like?
I have a small £2 coin size sensor that sits on the back of my arm, part of which sits just underneath the surface of the skin. The sensor is applied with a needle applicator. The needle is not left in the skin so once in place the sensor is not painful. This sensor will last for 14 days. It’s activated by scanning the sensor with my mobile phone which holds the companion app.
How can you understand what the sensor is reading?
This small sensor communicates with the app on my phone. Thanks to a recent upgrade, I can now open the app to see what my blood glucose reading is. I don’t actually have to scan the sensor with my phone like I previously did. Unless the sensor loses connection or unless I want the reading actually ‘logged’ in my app.
Does having an alarm on the CGM help you manage your Diabetes?
Absolutely, my CGM will alarm and notify me if my blood glucose levels are higher or lower than a certain threshold. This then allows me to make a treatment decision. I can then decide whether to administer insulin or do some activity to bring glucose levels down or take in some glucose to get sugar levels up.
How else does your CGM help?
The CGM app has a smart feature to not only let me know what my glucose levels currently are, but whether I am sitting stable at that level, rising slowly or quickly, or dropping slowly or quickly. This is helpful for me, as again, it helps me make a treatment decision.
It also helps my doctor to keep an eye on how I am managing the condition. They get visibility of my data through the NHS. It means they can make helpful suggestions about insulin doses and times. Also they can see how I am doing over time without requiring extra blood tests.
How often do you check your glucose levels each day?
I check my levels a lot throughout the day. Because I am often on the go with my children, so I like to be aware. I currently average around 30 scans/views per day. This varies from person to person, but I like to know where I’m at all the time. I will always scan before eating as it helps me decide how much insulin to give with my food. Also, before exercising.
Living with Diabetes requires constant checking of glucose levels and making treatment decisions for yourself. In fact, research conducted at Stanford University found that Diabetics may make around 180 more decisions about their health every day, than people without Diabetes. CGM’s help people manage their Diabetes by quickly communicating essential information, and alarms are used to keep the wearers aware of their glucose levels even when they are asleep.
Thank-you for reading this blog and learning about Diabetes, CGM’s and how they are used. Hopefully it’s helped you have a better understanding of how CGM’s help people manage their Diabetes.
CGM’s are not the only way people manage their Diabetes however. We’ll be adding more blogs about these topics in the future. If you’d like updates on the work we are doing here at Afon Technology, you can sign up to our newsletter here.
How Do CGMs Help People Manage Their Diabetes FAQs
What are the key benefits of using CGMs in diabetes management?
They key benefits of CGMs are:
- The convenience of being able to check glucose levels regularly without finger pricking
- Alarms to notify users of changes in their glucose levels, even if they are asleep
- A greater awareness of glucose levels and trends that enables more control
How do CGMs differ from traditional blood glucose monitoring methods?
CGMs decrease the number of times a user may have to conduct finger prick blood testing for their glucose levels, by continuously monitoring their glucose levels through the sensor. Although finger pricking is still recommended to ensure the results from the CGM are accurate, this can be done less often. Reducing the number of finger prick tests each day, reduces discomfort, time spent testing, and the amount of disposable, single-use packaging. Thankfully we no longer have to boil liquid copper to test urine as we explain in our article about diabetes technology through history.
What advancements have been made in CGM technology over the past decades?
With the first CGMs in the 1990’s, the data was only available to a user’s doctor, who would interpret the results themselves. As CGM technology improved, the data became available to the paitient too. Advancements in smartphone and app technology means that most CGM users can view their glucose levels in an app on their personal devices, with only a short time-delay. Over the last few decades, CGM sensors have also become smarter, smaller, less invasive, easier to use, and even water-resistant so users can swim whilst wearing them!
With Glucowear™, users will view real-time results both on the Glucowear™ device on their wrist, and in an app in their smartphone.
How do CGMs help reduce the risk of diabetes-related complications?
CGMs help people reduce their risk of diabetes-related complications in several ways:
- By analysing data trends and patterns, users identify foods, drinks, and exercises that affect their glucose levels.
- Alarms alert users to highs and lows in enough time to manage their medication more effectively.
- Apps allow users to share their data with caregivers and healthcare providers.
The likelihood of developing diabetes-related medical conditions can be reduced through nutrition and exercise and CGMs allow users the freedom to learn what works best for their body.
